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OhioBWC - Provider - Service:  (ICD-9 Groups)

ICD groups

ICD diagnosis code groups
BWC has arranged International Classification of Diseases (ICD) diagnostic codes into groups that facilitate managed care organization (MCO) and BWC evaluation of medical bills for relatedness to a specific claim. An ICD group contains individual codes that are similar in nature and/or involve the same body part.

Groups are built so that codes in that group can be used interchangeably in the medical reimbursement process. They are, however, not the sole item used in determining the relationship between the treatment or services provided and the claim reimbursement.

The document provided below is not intended as a coding tool, but rather as a resource to allow medical providers to understand what MCOs and BWC may consider to be related conditions. BWC requires providers to use national coding standards in creating bills to be submitted to MCOs, self-insured employers or BWC. Providers who have questions about whether services are related to a claim should contact the appropriate resource, the MCO for state-fund claims or the self-insuring employer biller.

Download the ICD groups.
If you have any questions about the groups, email BWC Medical Services.